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Post-Graduate Training of Faculty at National Emergency Medicine - CCM Conferences

机译：国家急诊医学系研究生培训-CCM会议

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Emergency medicine (EM) encompasses the care of diverse patient presentations of disease and injury. As such, EM incudes the practice of virtually all specialties to some extent but primarily deals with resuscitation and stabilization, which is generally considered to be the first 20-60 minutes of care in the Emergency Department (ED).(1) Although only approximately 5% of ED patients are critically ill, Emergency Physicians (EPs) may spend up to one third of their total time doing critical care since these patients may remain in the ED for extended times awaiting an ICU bed.(1,2,3) EPs are tasked with having a very wide breadth of knowledge in order to recognize, diagnose and initiate treatments before handing over the patient to another medical or surgical specialty provider for ongoing and definitive care. Therefore EM is a specialty that although distinct in its approach and goals for patient care, includes aspects of all of the specialties such as Internal Medicine, Surgery, Pediatrics, Ob/GYN, Psychiatry, etc.Since EM focuses on the resuscitation and stabilization of the most ill and injured patients, there are certainly aspects of critical care medicine involved with EM.(1,4) Indeed, critical care has been defined as the triad of resuscitation, emergency care and intensive care that spans the continuum from pre-hospital to the ED and into the ICU.(3,5) However, the continued assessment and care after their acute resuscitation is not a focus of EM training as there are no specific critical care topics in the EM model curriculum.(2,4,6) There are some specialties with formal fellowship training available to EM physicians; Pediatric EM, Sports Medicine, Toxicology, Hyperbaric and Undersea Medicine, Hospice and Palliative Medicine, Emergency Medical Services (EMS), and Critical Care Medicine (offered through ABIM, ABA, or ABS programs) are the current ACGME approved fellowships for EM program graduates; there are also other non-accredited training programs available such as emergency ultrasonography, ED administration, international EM, and more. There are numerous conferences advertised as some combination of Emergency Medicine and Critical Care Medicine (EM-CCM) but the background and qualifications of the speakers at these conferences is not well known. We were to review the post-graduate training of the speakers at seven prominent EM-CCM educational conferences to determine if they have training in both EM and CCM as compared to training only in EM.We reviewed the course programs for the training and background of the faculty speakers at seven prominent national EM-CCM conferences from 2008 -2012: America College of Emergency Physicians (ACEP) Scientific Assembly – Critical Care Medicine Tract, Critical Points: Emergency Critical Care, The Weil Symposium on Critical Care and Emergency Medicine, Emergency and Critical Care Medicine –“The Cutting Edge”, Florida Emergency Physicians Symposium on Critical Care in the Emergency Department, University of Maryland EM – The Crashing Patient, and Resuscitation. Confirmation of post-graduate training was performed by on-line research of the speaker’s academic department bioprofile. As a reference, we compared the percentage of speakers trained in both EM and CCM with the post-graduate training of the speakers at the ACEP Pediatric Emergency Medicine Assembly from 2010-2012 who have training in both Pediatrics and Emergency Medicine as compared to Emergency Medicine or Pediatrics alone.There were a total of 221 speakers at the seven studied EM-CCM conferences from 2008-2012: faculty trained in EM-CCM 42 (19.1%) and trained in EM alone 179 (80.9%).[see figure 1] There were 58 speakers at the ACEP Pediatric Emergency Medicine Assembly from 2010-2012: faculty trained in Peds-EM 29 (50.0%), Pediatrics plus subspecialty [critical care, cardiology, dermatology, etc.] 23 (39.6%), EM plus subspecialty [ultrasound, toxicology, etc.] 4 (6.9%), Pediatrics alone 1 (1.7%), and EM alone 1 (1.7%)
机译：急诊医学（EM）涵盖各种疾病和伤害的患者表现。因此，EM在某种程度上促使几乎所有专业的实践，但主要涉及复苏和稳定，这通常被认为是急诊科（ED）的前20-60分钟护理。（1） 5％的ED患者病危，急诊医师（EP）可能会花费其总时间的三分之一用于重症监护，因为这些患者可能会在ED中待更长的时间以等待ICU病床。（1,2,3） EP的任务是拥有广泛的知识，以便在将患者移交给另一位医学或外科专业提供者进行持续和最终的护理之前识别，诊断和开始治疗。因此，EM是一个专业，尽管其在患者护理方面的方法和目标有所不同，但包括内科，外科，儿科，Ob / GYN，精神病学等所有专业的各个方面。 （EM）（1,4）实际上，重症监护已被定义为复苏，急诊和重症监护三联症，涵盖了从院前开始的整个过程。 （3,5），但是在急诊复苏后继续评估和护理并不是EM培训的重点，因为EM模型课程中没有特定的重症监护主题。（2,4， 6）EM医师可以提供一些具有正规研究金培训的专业;小儿EM，运动医学，毒理学，高压和海底医学，临终关怀和姑息医学，急诊医疗服务（EMS）和重症监护医学（通过ABIM，ABA或ABS计划提供）是ACGME目前为EM计划毕业生批准的奖学金;还有其他未经认可的培训计划，例如急诊超声检查，急诊室管理，国际EM等。有许多会议宣传为急诊医学和重症监护医学（EM-CCM）的某种组合，但发言人的背景和资格并不为人所知。我们将在七个著名的EM-CCM教育会议上审查演讲者的研究生培训，以确定与仅接受EM培训相比，他们是否接受过EM和CCM培训。在2008年至2012年的七次全国重要EM-CCM会议上，该系的讲者是：美国急诊医师学院（ACEP）科学大会–重症监护医学领域，关键要点：紧急重症监护，关于重症监护和急诊医学的Weil专题讨论会，紧急情况和重症监护医学–“前沿”，马里兰大学EM急诊科佛罗里达急诊医师重症监护专题研讨会–坠毁的病人和复苏。演讲者学术部门生物特征的在线研究完成了对研究生培训的确认。作为参考，我们比较了接受过EM和CCM培训的演讲者与2010-2012年ACEP儿科急诊医学大会上接受过儿科和急诊医学培训的演讲者的研究生培训比例，并将其与急诊医学进行了比较。从2008年至2012年，在七个研究的EM-CCM会议上共有221位演讲者：教师接受过EM-CCM培训42（19.1％），仅接受过EM-CCM培训179（80.9％）。[见图1]。 ]在2010-2012年的ACEP儿科急诊医学大会上，有58位演讲者：接受过Peds-EM 29（50.0％），儿科和专科[重症监护，心脏病学，皮肤病学等] 23（39.6％），EM培训的教师加上专科（超声，毒理学等）4（6.9％），仅儿科1（1.7％），仅EM 1（1.7％）

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